摘要
目的 :探讨在自体骨髓 (造血干细胞 )移植技术支持下应用选择给药时间的高剂量的环磷酰胺、依托泊苷、阿糖胞苷和表柔比星等组成COAE预处理化疗方案治疗预后差的中高度恶性非霍奇金淋巴瘤 (NHL)的疗效。方法 :观察 11例患者应用本方案治疗后造血与免疫功能重建、长期无病生存率、毒副作用及移植相关死亡等 ,选用Kaplan Meier生存曲线评估移植后五年无病生存率 ,COX回归模型分析性别、年龄、预处理方案、移植时状态等对无病生存时间的影响。结果 :所有病人均获得造血与免疫功能重建 ,除 3例在移植后 1年内复发外 ,其余病人至2 0 0 0年 5月持续完全缓解 (CR)期分别为 73、6 3、35、30、2 7、2 0、16、8月。预期 5年无病生存率为 73%。结论 :本法在给药时间上进行了创新 ,使疗效提高 ,并减低了高剂量化疗的毒副作用。本法作为有不良预后因素的中高度恶性NHL患者诱导化疗达CR后强化治疗手段的远期疗效显著。
Purpose:To explore the effectiveness on the patients with poor prognosis and intermediate or high-grade non-Hodgkin's lymphoma (NHL) chronology of high-dose chemotherapy, including cyolophosphamide,etoposide etoposide cytosine arabinoside and epirubicin(COAE) , following autologous bone marrow transplantation (ABMT).Methods:11 NHL patients were treated by this method. The reconstitution of hematopoiesis and immunity was observed post-transplantation. The long-term survival, the side effects and transplantation-related-death of all the patients were investigated. Kaplan-Meier survival analysis model was used to estimate the disease-free-survival (DFS) at 5 years post-transplantation and COX regression model to analyze the factors influencing the DFS, which included sex, age, kinds of pathology, conditioning regimen,etc. Results:All the patients reconstituted hematopiesis and immunity. Except for 3 patients who had relapse one year after-transplantation, others remained in CR for 73, 63, 35, 30,27, 20, 16, 8 months until May, 2000. The actuarial 5 years DFS in patients with NHL was 73%.Conclusions:This high-dose COAE regimen with changes in chronology of chemotherapy reduces the relapse and toxicity , and increases the long-term-survival. Its long-term effect is significant for the patients with poor prognosis and intermediate or high-grade NHL after CR.
出处
《中国癌症杂志》
CAS
CSCD
2001年第2期128-130,共3页
China Oncology
基金
山东临沂市科委项目 (No .96 10 33)
关键词
非霍奇金淋巴瘤
择时化疗
自体移植
长期随访
骨髓移植
non-Hodgkin's lymphoma
chronochemotherapy
transplantation autologous
long-term follow-up
